Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea.
Retina. 2018 Nov;38(11):2168-2176. doi: 10.1097/IAE.0000000000001845.
To investigate morphologic features associated with fibrotic scarring after anti-vascular endothelial growth factor therapy in polypoidal choroidal vasculopathy (PCV).
This retrospective study included 293 patients who had been diagnosed with PCV and treated with anti-vascular endothelial growth factor monotherapy during a 12-month follow-up period. Associations of morphologic features, including type of PCV, location of the polypoidal lesion, greatest linear dimension, largest polyp diameter, choroidal vascular hyperpermeability, pigment epithelial detachment, intraretinal fluid, and subretinal hyperreflective material (SHRM) with fibrotic scar at 12 months were analyzed.
Fibrotic scars were noted in 15 eyes (5.1%). The incidence of fibrotic scars was higher in Type 1 PCV (8 of 76 eyes) than in Type 2 PCV (7 of 217 eyes, P = 0.028). The incidence was also higher in eyes with SHRM (14 of 124 eyes) than in eyes without SHRM (1 of 169 eyes, P < 0.001). In multivariate analysis, SHRM was associated with fibrotic scar (P = 0.005). Among the SHRM cases, the incidence of the scar was 12.9% in eyes with submacular hemorrhage and 8.5% in eyes without hemorrhage.
Although fibrotic scar is an infrequent finding in PCV, the possibility of scarring should be considered in eyes with SHRM, particularly in submacular hemorrhage cases.
研究与息肉样脉络膜血管病变(PCV)抗血管内皮生长因子治疗后纤维化瘢痕相关的形态特征。
本回顾性研究纳入了 293 名在 12 个月的随访期间接受抗血管内皮生长因子单药治疗的 PCV 患者。分析形态特征(包括 PCV 类型、息肉样病变位置、最大线性尺寸、最大息肉直径、脉络膜血管通透性、色素上皮脱离、视网膜内液和视网膜下高反射物质(SHRM))与 12 个月时纤维化瘢痕的相关性。
15 只眼(5.1%)出现纤维化瘢痕。1 型 PCV 中纤维化瘢痕的发生率(8/76 眼)高于 2 型 PCV(7/217 眼,P = 0.028)。SHRM 眼(124 眼中有 14 眼)的纤维化瘢痕发生率高于无 SHRM 眼(169 眼中有 1 眼,P < 0.001)。多变量分析显示,SHRM 与纤维化瘢痕相关(P = 0.005)。在 SHRM 病例中,有黄斑下出血的眼的瘢痕发生率为 12.9%,无出血的眼的瘢痕发生率为 8.5%。
尽管纤维化瘢痕在 PCV 中是一种罕见的发现,但在 SHRM 眼中,特别是在有黄斑下出血的病例中,应该考虑到发生瘢痕的可能性。